Introduction: trauma to the maxillary anterior teeth is often encountered, especially in teenagers. Severe trauma can result in pulp death and even periapical lesions if left untreated. This case report aims to evaluate periapical lesions in root canal treatment with anterior tooth fractures. Case report: A 21-year-old man came to RSGM UMY with complaints of a broken left front tooth. Teeth have been broken since early high school, around 16 years old. Clinical examination showed tooth 21 an Ellis class II fracture with caries in the fracture area in the mid and distal teeth. Apart from that, there was a vesicular lesion on the mucosa parallel to tooth 21 at 5 mm above the gingival margin, which was painless. Based on radiograph examination, a fracture of 1/3 of the crown is visible, there is a periapical lesion with a lesion size of approximately 5 mm, the lamina dura and periodontal ligament are broken in the apical 1/3. Case management: Root canal treatment was performed on tooth 21 to eliminate or reduce bacteria in the root canal. The sealer for treatment uses eugenol based. Results: The results showed that there was a significant change in the apical lesion at the beginning of the visit until the second control was carried out. Conclusion: Adequate root canal treatment can cure periapical lesions and bone regeneration in cases of chronic periapical abscess